The present invention relates to a therapeutic method for treating weight loss linked to inflammatory bowel diseases (IBD), such as Crohn's disease and ulcerative colitis.
Inflammatory bowel diseases are chronic relapsing conditions of the intestinal tract for which essentially no therapy is available. The major known forms of IBD are Crohn's disease and ulcerative colitis (see Carter et al. (2004) Gut 53(supplement V):v1-v16 for a review).
Crohn's disease was first described in 1932 and its prevalence is as high as 75/100,000 in Britain and Scandinavia. It mainly affects the ileon and/or the colon, with 60% of patients suffering from an ileocolonic form of the disease. Its clinical manifestations include abdominal pain, nausea, diarrhea, anorexia, abdominal tenderness, and weight loss.
Ulcerative colitis (UC) was first completely described in 1909, its prevalence is approximately 80/100,000 in the Northern world. UC affects the colonic and rectal mucosa. Among others, it is manifested by pain, diarrhea, rectal bleeding, anorexia, and weight loss.
Current treatments of IBD aim at inducing and preserving remission and mainly rely on corticosteroids, such as prednisone, aminosalicylates, such as mesalazine, immunosuppressants, and anti-TNF monoclonal antibodies, such as infliximab. If a patient fails to respond to drug therapy and relapses, a surgical intervention is usually deemed mandatory to remove the dysfunctional part of the intestinal tract.
Saccharomyces boulardii (Sacharomyces cerevisiae var. boulardii, Mallié et al. (2001) J. Mycol. Med. 11:19-25) is a thermophilic non pathogenic yeast. Clinically, S. boulardii is essentially used as a probiotic for short course prevention or treatment of diarrhea. It is used in particular for the management of antibiotic-associated diarrhea (McFarland et al. (1998) Am. J. Gastroenterol. 90:439-448) and for the prevention of Clostridium difficile-associated diarrhea (Surawicz et al. (2000) Clin. Infect. Dis. 31:1012-1017). S. boulardii has also been used in association with conventional drug treatment to reduce Crohn's disease-associated diarrhea (Plein and Hotz (1993) Z. Gastroenterol. 31:129-134).
Weight loss in inflammatory bowel disease is multifactorial. Proinflammatory cytokines (IL-1, IL-6 and TNFα) from the inflamed intestinal mucosa are known to have several effects leading to disruption of normal metabolism (Jahnsen et al. (2003) Am. J. Gastroenterol. 98:1556-1562). However, there are currently no therapeutic methods effective at specifically treating weight loss in IBD patients.
Thus, an object of the present invention is to provide a therapeutic method for treating weight loss in patients suffering from inflammatory bowel diseases.